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Team Approach: Contemporary Treatment of Congenital Scoliosis

Karaarslan, Umut Can1; Gurel, Ipek Ege1; Yucekul, Altug MD2; Demirkiran, H. Gokhan MD3; Samdani, Amer MD4; Yilgor, Caglar MD5; Alanay, Ahmet MD5

doi: 10.2106/JBJS.RVW.19.00001
Team Approach Review Articles
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  • » Congenital scoliosis is caused by developmental abnormalities such as failure of segmentation, failure of formation, or a combination of these conditions.
  • » The multi-organ nature of congenital scoliosis necessitates a team approach in which spinal and intraspinal deformities are treated by orthopaedic surgeons, neurosurgeons, and physical therapists, and associated anomalies are treated by pediatricians, pediatric surgeons, cardiologists, pulmonologists, and urologists.
  • » At the initial time of diagnosis, observation is appropriate for most cases. Although early arthrodesis may be appropriate for select cases, delaying tactics that are nonoperative (bracing and casting) or operative (growing rod and growth guidance) may preserve (or even stimulate) spine and chest cage development while controlling the deformity.
  • » Early hemivertebra resection and short-segment arthrodesis provide excellent outcomes.
  • » Patients with a neurological deficit may require neurosurgical intervention, which may be performed either before a deformity correction surgical procedure or simultaneously with the procedure.

1Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey

2Comprehensive Spine Center, Acibadem Maslak Hospital, Istanbul, Turkey

3Department of Orthopedics and Traumatology, Hacettepe University School of Medicine, Ankara, Turkey

4Department of Neurosurgery, Shriners Hospital for Children, Philadelphia, Pennsylvania

5Acibadem Mehmet Ali Aydinlar University School of Medicine, Department of Orthopedics and Traumatology, Istanbul, Turkey

E-mail address for A. Alanay: aalanay@gmail.com

Investigation performed at Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey

Disclosure: The authors indicated that no external funding was received for any aspect of this work. On the Disclosure of Potential Conflicts of Interest forms, which are provided with the online version of the article, one or more of the authors checked “yes” to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work and “yes” to indicate that the author had other relationships or activities that could be perceived to influence, or have the potential to influence, what was written in this work (http://links.lww.com/JBJSREV/A492).

Copyright © 2019 by The Journal of Bone and Joint Surgery, Incorporated
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